Bronchial asthma in top athletes.
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Adolescent↗
Biomedical subjects
A Dal Monte
Publications and source records attributed to A Dal Monte.
Osteosarcoma of the proximal femur and humerus in children treated by resection, endoprosthesis and complementary chemotherapy.
Three cases of osteosarcoma of the proximal femur and humerus in children are reported. They were all highly malignant. They were treated by radical resection and prosthetic replacement with complementary chemotherapy. At 6 months, 2 years and 7 months, and 3 years and 2 months respectively they show no signs of local recurrence or metastases.
Artificial Limbs↗
Late sequelae of Perthe's disease (long-term follow-up of 34 hips).
The long-term results were studied in 31 patients (34 hips) with Perthe's disease. The patients were divided into two groups (above and below 25 years of age) in order to study the time at which the late complications become clinically and radiologically evident. The incidence of painful hip and radiological arthrosis is reported in each group in relation to age and initial grade of the disease. The significant prognostic factors were the initial severity of the disease (Types 1-3), the age at which it appeared, and the shape of the femoral head as assessed by the method of Mose. Treatment had been so varied that it was excluded as a factor in our analysis. The development of painful hip and radiological arthrosis (not always painful) only appeared to a significant extent in patients over the age of 25 at follow-up, and both were directly related to the initial grade of the disease.
Adolescent↗
The treatment of congenital constricting bands by Ombredanne's two stage operation. Review of 13 cases.
The authors report their experience in the treatment of congenital constricting bands by Ombrédanne's two stage operation. Fourteen bands completely encircled the limb and 2 were incomplete. The patients were followed up from 6 months to 15 years (average 3 years) and in all cases the results were excellent. The literature on the pathogenesis is reviewed.
Amniotic Band Syndrome↗
Relationships between body composition, leg strength and maximal alactacid anaerobic power in trained subjects.
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Adolescent↗
Congenital clubfoot: results and therapeutic guidelines.
The authors report the results observed between 5 and 11 years after surgery in 100 cases of congenital clubfoot treated by posterior release and another 100 cases treated by combined posterior and medial release. On the basis of their experience, they believe that: 1. Grade 1 clubfoot can be successfully treated conservatively; 2. Grade 2 and grade 3 clubfoot must always be treated by complete posterior and medial release; 3. The best age for surgical intervention is around the age of 3 months; 4. In the first three months of life, manipulation and plaster casts should be used to try to correct the deformity.
Age Factors↗
Post-traumatic genu valgum in children.
The authors present 16 cases of post-traumatic genu valgum in children and discuss the pathogenesis of the deformity. In addition to mechanical factors (imperfect reduction of the fracture, inadequate immobilization, "bow string" effect of the intact fibula and the antero-lateral muscles of the thigh, altered load-bearing axis) there are biological factors of much greater importance. These are damage to the lateral aspect of the proximal growth cartilage of the tibia, with augmented growth on the medial side due to stimulation at the fracture site and periosteal detachment. All our cases were treated by osteotomy and there were 7 partial relapses, the causes of which are discussed. Osteotomy is tantamount to a second fracture, so must have regard to the pathological factors related to relapse. The authors recommend that corrective osteotomy of the tibia should always be associated with osteotomy of the fibula to avoid the "bow string" " effect. They also advise over correction of the deformity by about 5 degrees and immobilization in a full spica plaster to ensure maintenance of correction and rapid healing. For the same reason, perfect contact between the osteotomised surfaces is essential.
Bone Diseases, Developmental↗
The natural history of unicameral bone cyst after steroid injection.
Ninety-five consecutive cases of unicameral bone cyst treated at the Istituto Ortopedico Rizzoli by intracystic injections of methylprednisolone acetate were retrospectively reviewed. Eighty per cent of the patients had a satisfactory result. Of the 20% failures, 13.5% had a recurrence of the cyst. Recurrence after methylprednisolone acetate treatment is a previously unrecognized entity, with recurrence risk factors associated with multiloculation, cyst size and age of the patient.
Adolescent↗
Cardiotelemetric and blood lactate investigations in paraplegic subjects during several sports activities.
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Adult↗
Osteogenesis imperfecta: results obtained with the Sofield method of surgical treatment.
The authors report the results obtained in thirteen patients with osteogenesis imperfecta who were treated by the Sofield operation. This operation is indicated both in the congenital and delayed forms of the disease. The results are promising: prevention of deformities and fractures in a high percentage of cases, recovery of the ability to walk in all the patients. The incidence of complications was low, infection being the most serious. Although the use of extending rods reduces the number of reinterventions, it does not appear to improve the results and carries the risk of a greater number of complications. However, the authors have no experience of this particular technique.
Adolescent↗
Results in the late treatment of congenital dislocation of the hip.
The results obtained in the treatment of seventeen cases of long established (more than six years) congenital dislocation of the hip are reported. They were followed up for one to five years after operation. The writers consider osteotomy to correct leg length discrepancy to be unnecessary. Triradial osteotomy of the pelvis ensures optimal epiphyseal coverage and permits moderate lengthening of the limb. In the writers' experience, osteochondrosis is not related to the type of osteotomy, nor to operations to produce leg lengthening; it can be avoided by the use of prolonged post-operative traction.
Adolescent↗
Tenomyoplasty of the flexor muscles in the surgical treatment of congenital recurvatum, subluxation and dislocation of the knee.
The writers present eight cases of congenital recurvatum or dislocation of the knee in which tenomyoplasty of the flexor muscles of the knee was performed. The operation was the only one used in cases with flexion greater than 60 degrees, while in cases of more severe loss of flexion, it was supplementary to mobilisation of the quadriceps according to Judet's technique. The technique of tenomyoplasty is described and the results are reported. These are considered to be favourable.
Child, Preschool↗
Surgical treatment of metatarsus varus during the growth period.
The writers describe their experience in the treatment of congenital metatarsus varus. They describe an original technique for anterior transfer or shortening of peroneus brevis which they consider to be indicated when the varus deformity is less than 15 degrees and is correctable manually. They also describe Heyman's technique and give their results in twenty-five cases. They consider that this operation is indicated only for varus deformity of the forefoot exceeding 15 degrees which is correctable manually. In both these techniques it is essential that the hindfoot should be in the correct midline axis. Where manual correction of the hindfoot is not possible they advise Dillwyn Evans' operation. In varus deformity of the 1st metatarsal exceeding 15 degrees, and not correctable manually, they suggest osteotomy of the base of this bone, displacing it the correct degree and fixing it with a wedge of homoplastic bone inserted into the gap.
Child↗
Long term results of centralising intertrochanteric osteotomy in Legg-Calvé-Perthes' disease. (Report on 60 cases).
The writers propose a new classification of Legg-Calvé-Perthes' disease into three degrees of increasing gravity. Grade 1 includes hips with minimal or no flattening of the epiphysis, normal relations between the head of the femur and the acetabulum, and a normally orientated epiphyseal cartilage. Grade 2 comprises hips with slight epiphyseal flattening (one third or less), the epiphyseal growth cartilage is horizontal, the femoral head is partly uncovered due to epiphyseal subluxation, but becomes normal in the abduction test. Grade 3 hips show severe epiphyseal flattening (more than one third), the epiphyseal growth cartilage is horizontal, and the epiphyseal subluxation persists even in the abduction test. In our opinion, the advantage of this classification, which is not dependent on a determination of the extent of the necrosis, is that it is less subjective, and can be applied more easily and immediately, as compared with Catterall's classification. The results in sixty cases of intertrochanteric centralising osteotomy were constantly satisfactory in grades 1 and 2, but unsatisfactory in grade 3. The writers consider that surgical intervention is unnecessary in patients with hips in grade 1, while femoral osteotomy is contra-indicated in grade 3 cases. In the latter event, surgical intervention, if considered necessary, should be a pelvic osteotomy or cheiloplasty of the femoral epiphysis. Centralising osteotomy is the operation of choice in patients of grade 2. The results were better in patients who were less than six years of age at the time of operation.
Adult↗
Lengthening of the radius or ulna in asymmetrical hypoplasia of the forearm (report on 7 cases).
Six cases of lengthening of the ulna, and one of lengthening of the radius in hypoplasia of the forearm are reported. The surgical technique and the results obtained one to three years after operation are described.
Bone Lengthening↗
Acetabuloplasty by triple pelvic osteotomy: indications and surgical technique.
Triple pelvic osteotomy (or triradiate osteotomy) enables a Salter innominate osteotomy to be performed in older children, or even in adults. The displacement of the acetabular fragments is made possible by a double osteotomy near the symphysis in the anterior pelvic girdle. After the age of seven to eight years, the lack of elasticity in the symphysis pubis makes it technically difficult to perform a classic Salter osteotomy. On the basis of a study of the first twenty cases in which the operation was performed, the authors discuss the indications and describe the surgical technique for this operation, which enables excellent acetabular roof cover to be provided in dysplastic hip joints in which the femoral head can still be centered.
Acetabulum↗
Results of surgical treatment of idiopathic pes plano-valgus by means of Grice's operation combined with reconstruction of the glenoid (accessory plantar) ligament and anterior transposition of tibialis posterior. (A review of 90 cases).
After an average follow up of six years, the writers reviewed the results of ninety operations for idiopathic flat foot treated by Grice's operation combined with reconstruction of the glenoid ligament and anterior transposition of the tibialis posterior. Eleven parameters (clinical, plantographic and radiographic) were used for objective assessment of the initial and residual deformity, a numerical code being given to each. The results were excellent or good in 88 per cent of the patients. The initial severity of the condition and the presence of ligamentous laxity either generalised or localised to the ankle joint, had an adverse effect on the results. The technique of Grice's operation is extremely important. The results are always excellent or good when the sinus tarsi is widely opened up and the bone graft correctly placed. Anterior transposition of the tibialis posterior improved the results in 26 per cent of cases: elongation of the Achilles tendon was only rarely necessary. The type of graft had no effect on the results: homoplastic grafts are therefore preferable since they cause less inconvenience. Surgical intervention before the age of four years is a mistake: the best results are obtained between nine and thirteen years.
Adolescent↗
Therapeutic problems in the treatment of cartilaginous tumours of bone.
Two cases of solitary cartilaginous bone tumours are presented. They were slow growing and the radiographs never showed any certain evidence of malignancy. The writers emphasize the difficulties in planning treatment, in view of the tendency towards malignancy shown by these tumours.
Adolescent↗